156

Research Article

Türk Fen ve Sağlık Dergisi

Turkish Journal of Science and Health

Volume 2 Number 1 Year 2021 Pages 156-165

ISSN: 2717-7173 https://dergipark.org.tr/tr/pub/tfsd

Received: 11.12.2020 Accepted: 24.01.2021

Hemşirelik Öğrencilerinin Etik Duyarlılıklarına ve Mesleki Gelişimlerine Sosyal Medyanın Etkisi**

Şahizer Eraydın1* , Arzu Erkoç Hut2

1Tokat Gaziosmanpasa University Faculty of Health Science, Division of Nursing, Department of Fundamentals of Nursing, Tokat, Turkey

2Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Medical Nursing Department, Istanbul, Turkey

ÖZET: Amaç: Bu araştırma, hemşirelik öğrencilerinin mesleki gelişimleri için sosyal medyada kurdukları bağlantılarını belirlemek ve sosyal medyanın etik duyarlılıkları üzerine etkisini incelemek amacıyla yapılmıştır. Gereç ve Yöntem: Tanımlayıcı ve kesitsel türdeki bu araştırma, 316 hemşirelik öğrencisi ile gerçekleştirilmiştir. Araştırmanın verileri öğrencilerin sosyal medya kullanımlarına yönelik anket formu ve Ahlaki Duyarlılık Anketi (ADA) ile toplanmıştır. Araştırma verileri SPSS 22 programında değerlendirilmiştir. Verilerin analizinde, frekans dağılımı, aritmetik ortalama, Varyans analizi ve ikili gruplarda t testi kullanılmıştır. Bulgular: Öğrencilerin, yaş ortalamaları 20.52 ± 1.7 olup, % 70.6’sı kız öğrencidir. Öğrencilerin ADA toplam puan ortalamaları 111.89 ± 36.78’dir. Sınıflar ve cinsiyetler arasında ADA ölçeğinin puanları yönünden istatistiksel fark yoktur (p<0.05). Öğrenciler günlük % 44’ü 4-5 saat, % 35’i 6 saatten fazla sosyal medyayı kullanıyor. Büyük oranda sosyal medya bilgilerine güvenmedikleri, inanmadıkları ve paylaşımlardan endişe duydukları bulunmuştur. Öğrencilerin %40’ı mesleki bilgilerini sosyal medya aracılığı ile geliştirmektedir. Sonuç: Hemşirelik öğrencilerinin etik duyarlılığının orta düzeyde olduğu, sosyal medyayı çok kullandıklarını, içeriklerine güvenmedikleri, mesleki gelişim için sosyal medya kullandıklarını, öğrencilerin etik duyarlılıklarının sosyal medyadan etkilenmediği söylenebilir. Anahtar Kelimeler: Etik duyarlılık, sosyal medya, mesleki gelişim, hemşirelik öğrencileri

The Effect of Social Media on Nursing Students’ Ethical Sensitivity and Professional Development

ABSTRACT: Purpose: This study was conducted to determine the connections that nursing students established for their professional development on social media and investigate the effect of social media on their ethical sensitivity. Material and Methods: This descriptive and cross-sectional study was conducted on 316 nursing students. Data of the study were collected using a questionnaire form about students’ social media use and the Moral Sensitivity Questionnaire (MSQ). The data were analyzed using SPSS 20 software package. Frequency distribution, arithmetic mean, Variance analysis, and t-test groups of two were employed in data analysis. Results: The mean age of the students was 20.52 ± 1.7 and 70.6% of them were female. The mean total MSQ score of the students was 111.89 ± 36.78. There was no statistically significant difference between classes and genders in terms of MSQ scores (p<0.05). Students use social media for long hours. But, students did not trust and believe the information on social media and that they were concerned about the material shared. 40% of students were found to develop their professional knowledge through social media. Conclusion: It can be said that the ethical sensitivity of the nursing students was at a moderate level, they frequently used the social media, they did not trust the social media content, they utilized social media for their professional development, and that the ethical sensitivity of the students was not affected by the social media. Keywords: Ethical sensitivity, social media, professional development, nursing students *Corresponding author: Şahizer Eraydın, email: sahizer.eraydin@gop.edu.tr ** Bu Çalışma Erzurum’da 10-12 Eylül 2015 tarihlerinde gerçekleştirilen 15. Ulusal Hemşirelik Kongresinde poster bildiri olarak sunulmuştur.

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INTRODUCTION

Today, giving ethically safe care is an indispensable

element of the nursing profession. Devotion to

ethical criteria is considered to be one of the

professional qualities for nurses (Leuter et al., 2012).

Ethics in nursing is important in developing a moral

perspective on ethical issues encountered especially

in nursing practices, protecting patient rights, and

ensuring patient safety (Gül et al., 2013; Yeom, Ahn,

Kim, 2017). Nurses often encounter ethical problems

in working environments. They make use of their

personal and professional values and professional

ethical principles for the solution of these ethical

issues (Sarı et al.,2018). Nurses’ ability to recognize

and distinguish ethical issues, and cope with them

are associated with their ethical decision-making

levels and ethical sensitivity (Cerit, 2010; Ertuğ et al.,

2014). Ethical sensitivity, which is defined as the

ability to recognize an ethical case, helps understand

patients or healthy individuals during the provision

of care to them and ensures that patients benefit

from the care (Park et al., 2012). An ethically

sensitive person forms an ethically defensible

judgment. The high ethical sensitivity of nurses will

directly affect the quality of nursing care given to

patients as well as contributing to

professionalization (Cerit, 2010; Cerit and Dinç,

2013). Studies on the ethical sensitivities of nurses

report that the ethical decision making and ethical

sensitivity of nurses was not at the desired level but

at a moderate level, and that the nurses' ethical

sensitivity increased as the year of schooling and

working year increased (Öztürk et al., 2009; Cerit,

2010; Başak, Uzun, Arslan,2010; Dikmen, 2013; Cerit

and Dinç, 2013; Ertuğ et al., 2014). Similar results

were found in studies with student nurses.

Improving ethical awareness and sensitivity in

nursing students' education and practice is highly

important for the execution of their profession after

graduation (Erdil and Korkmaz, 2009; Borhani,

Abbaszadeh, Mohsenpour, 2013; Akbaş et al.,2014;

Baykara, Demir, Yaman,2015; Sarı et al., 2018).

Ethical sensitivity of nursing students can be

improved during their education is stated. The

education of nursing students, should enable them

to recognize ethical problems and to develop the

right decision-making skills in ethical issues while

enabling their professional development (Yeom,

Ahn, Kim, 2017; Lee, Huang, Huang, 2017; Sarı et al.,

2018). At the same time, ethical sensitivity is stated

to develop students’ methods of providing care and

care decisions (Borhani, Abbaszadeh, Mohsenpour,

2013; Gül et al., 2013; Akbaş et al.,2014). Apart from

the training process, there are many factors that may

have an impact on students' ethical sensitivity such

as personal qualities/character, family education,

social environment, religion, culture, and media

(Burkhard and Nathanial, 2013). Today, social media

is thought to be one of the factors that affect the

ethical sensitivity. In recent years, as a result of the

development and spread of information

technologies and communication networks, people

share information instantly and carry out their social

interactions through the Internet. Social media is

increasingly becoming a habit that responds to the

social demands of a wide range of cultures. (Vural

and Bat, 2010; Solmaz et al., 2013; Button,

Harrington, Belan, 2014). Social media creates a

virtual environment that allows a wide variety of

different users from various fields and areas such as

entertainment, education, economics, health, trade,

politics to come together and share digital material

(Acun et al., 2017; Egüz and Kesten, 2018; Terzi et al.,

2019). People can freely share their thoughts on

social media, discuss these ideas, and put forward

new ideas. With this regard, social media can be the

medium of expression of personal ideas (Skiba, 2007;

Farrelly, 2014; Acun et al., 2017). With these

features, social media has become a powerful tool

that can affect personal and social values (Otrar and

Argın, 2014; Alharbi, Kuhn, Morphet, 2020).

In a study, it was found that university students used

social media more in order to find information and

get in contact with political groups (Acun et al.,

2017). In studies investigating the use of social media

in nursing education, students reported positive

views. They stated that facebook improved their

learning habits, learning strategies, increased their

participation in the course, and facilitated asking

questions (Watson, Cooke, Walker, 2016); doing

homework, sharing resources, getting peer advice

and instructor support helped their learning

(Ferguson et al., 2016; Terzi et al., 2019; Alharbi,

Kuhn, Morphet, 2020) and they learned about

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nursing, healthcare, and personal development

through the interaction with their peers and

instructors on Twitter (Jones et al., 2016). On the

other hand, midwifery students stated that while the

birth videos on Youtube allowed the professional use

of social media, it was also worrying about sexual

harassment and exploitation of women (Uppal et al.,

2016). Similarly, students stated in a study that

“employers could collect information about them

from Facebook, so they had to be cautious about

social media use”. They called attention to the

negative side of social media by expressing concerns

about privacy and professionalism (Ferguson et al.,

2016). In a virtual internet environment, people can

interact by constantly sharing regardless of time and

place (Terzi et al., 2019). This leads to the rapid

dissemination of information and ideas among

people who are constantly interacting. Sharing with

false identities can cause disinformation to spread

quickly. It is likely that personal information can be

shared without the consent of individuals. For this

reason, unauthorized sharing of information can

create ethical problems due to privacy violation and

the lack of responsibility (George and Dellasega,

2011; Schmitt, Sims­Giddens, Booth, 2012;

Tuominen, Stolt, Salminen, 2014; Green, Wyllie,

Jackson, 2014; Nemeth et al., 2016). Ethical

sensitivity, which has an important place in nursing

profession and education, can be affected by social

media which allows intensive interaction in virtual

environment and which has a widespread network

(Uppal et al., 2016; Ferguson et al., 2016). Social

media can positively / negatively influence students’

professional development. However, a review of the

related literature has indicated that there is no study

investigating the effect of social media on the ethical

sensitivities of nursing students. This study was

carried out to determine the relationships that

nursing students have on social media for their

ethical sensitivity and investigate the effect of media

on their ethical sensitivities.

MATERIAL and METHODS

Purpose and Type of the Study

This study was cross-sectional and descriptive. This

study was carried out to determine the relationships

that nursing students have on social media for their

ethical sensitivity and investigate the effect of media

on their ethical sensitivities.

Research questions:

1. What is the level of nursing students’ ethical

sensitivity?

2. What do students share on social media?

3. Do students use social media for their professional

development?

4. Does social media have an effect on the level of

nursing students’ ethical sensitivity?

Sampling and participant

In the study, the entire universe was targeted. The

study was completed with 316 of the 410 students

enrolled in the nursing department who voluntarily

participated in the study and answered all the

questions. Participation rate was 77.45%.

Data Collection Tools

For collecting data, a questionnaire form designed

based on the related literature (George and

Dellasega, 2011; Schmitt, Sims­Giddens, Booth,

2012; Tuominen, Stolt, Salminen, 2014; Green,

Wyllie, Jackson, 2014), and the Moral Sensitivity

Questionnaire (MSQ) were used. The questionnaire

form included 20 items questioning the socio-

demographic characteristics of the students and

their social media use (the frequency of using social

media, purpose of use, etc.) and 10 items

questioning social media use for social and

professional purposes (e.g. communicating with

instructors about the courses, communicating with

nursing associations, sharing problems related to

nursing, etc.).

Moral Sensitivity Questionnaire (MSQ): The scale

was developed by Lutzen in 1994 and adapted to

Turkish by Tosun in 2005. The scale consists of 30

items and 6 subscales. It is a 7-point Likert type scale,

where “1 point” means strong agreement with a high

sensitivity and “7 points” show strong disagreement

with a low sensitivity. The total score that can be

obtained from the scale varies between 30 and 210.

A high score is considered low ethical sensitivity,

whereas a low score indicates high ethical sensitivity.

Tosun (2005) reported a Cronbach alpha value of

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0.84 (Dikmen, 2013; Ertuğ et al., 2014; Tosun, 2018).

In our study, Cronbach's Alpha value of the MSQ

scale was found to be 0.96.

Data Collection: After the purpose of the study was

explained to the students, the questionnaire forms

were distributed to the students collectively. It took

10-15 minutes for each student to fill out the

questionnaire form.

Statistical Analysis

The IBM SPSS 22.0 (Chicago, IL, USA) software

package was used to analyze the data and

descriptive statistical methods (number, percentage,

mean, standard deviation) were utilized. The data

were evaluated with frequency distribution,

arithmetic mean, t-test, and Variance analysis and p

<0.05 was accepted as statistically significant.

Ethical Approval

This study was approved by the Scientific Research

Ethics Committee of Tokat Gaziosmanpaşa

University (Approval number: 15-KAEK-130). In

addition, the institutional permission of the Health

Sciences Faculty and the verbal consents of the

students were obtained. The research has followed

the principles of the Declaration of Helsinki. No

funding was received for the study.

RESULTS

In our study, the mean age of the students was 20.52

± 1.7 years and 70.6% of the students were female.

24.4% of the participants were first-year students,

25.9% second-year, 26.6% third-year, and 23.1%

were fourth-year students. The mean total MSQ

score used to determine the ethical sensitivities of

the nursing students was 111.89 ± 36.78. The mean

MSQ total scores for the first, second, third, and

fourth-year students were 120.27±41.33,

111.07±34.18, 107.07±38.60, and 109.53±31.26,

respectively. There was no statistically significant

difference between the groups in terms of mean

MSQ scores (p = 0.123; Table 1). When the mean

MSQ scores were compared by gender, the mean

score of the female students was found to be 111.04

±38.44 and the mean score of the male students was

111.93±32.2. No significant difference was found

between genders (p = 0.497; Table 1). While there

was no difference in terms of family income, the

place of residence, and the place where the student

lives with his/her family, there was a difference

according to the type of the family (p<0.05;Table 1).

Table 1. Demographic Features (n=316)

n (%) MSQ Mean±SD TEST P

Total MSQ for all the students 316 (100) 111.89±36.78

Class

Class 1 77 (24.4) 120.27±41.33

F=1.943 0.123 Class 2 82 (25.9) 111.07±34.18 Class 3 84 (26.6) 107.07±38.60 Class 4 73 (23.1) 109.53±36.78

Gender Female 223 (70.6 ) 111.04±38.44

t=0.681 0.497 Male 93 (29.4) 113.93±32.57

Family type Core family 248 (78.5) 110.66 ±35.56

F=4.625 .010* Extended family 58 (18.4) 111.22 ±37.58 Fragmented family 10 (3.1) 146.30 ±48.55

Family Income High 35 (11.1) 119.85±36.63

F=1.794 .168 Middle 239 (75.6) 112.11±36.97 Low 42 (13.3) 104.02±35.09

Accommodation status

Student Dormitory 167 (52.8) 107.28±36.27

F=2.188 .070

Family 78 (24.7) 112.61±34.40 Friends 56 (17.7) 121.25±37.32 Alone 7 (2.3) 132.28±46.72 Relatives 8 (2.5) 117.75±46.78

Living with his family County 133 (42.1) 111.52±40.25

F=0.029 .971 City 127 (40.2) 112.50±31.02 Village/town 56 (17.7) 111.39±40.70

F: One-way ANOVA t; TEST *p<0.05 MSQ: Moral Sensitivity Questionnaire

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The rate of social media use in our study was 96%. It

was found that 44% of the students used social

media daily for four to five hours, 35% used it for

more than 6 hours daily, Only 6.5% believed the

social media content, 3.9% trusted social media

information, and that 24.4% were not concerned

about information sharing. In addition, it was

determined that 69.4% of the students used social

media to get in contact with their friends, 45.2% for

sharing messages with friends, and 35.4% for sharing

photos/videos. It was found that 58.2% of the

students gave short responses to social media

comments, 12% gave no response at all, and that

39% explained their ideas honestly. No significant

difference was found between the status of the

students' social media use and their total scores from

MSQ scale (p> 0.05; Table 2).

Table 2. Students' Social Media Use and MSQ Mean Scores (n=316)

Views on social media use n % MSQ Mean±SD Test

Following social media Yes 303 95.9 112.48±36.13 t=1.385 Partly 13 4.1 98.07±49.45 p=0.167

Average duration of daily social media use

1-3 hours 64 21.1 113.57±36.65 F=0.112 p=0.894

4-5 hours 133 43.9 111.38±36.38

6 hours+ 106 35.0 113.21±35.82

Finding the content on social media credible Yes 20 6.5 115.25±37.57

F=0.149 p=0.862

No 78 25.2 112.70±39.75 Partly 212 68.3 111.15±34.73

Trusting social media content

Yes 12 3.9 107.33±38.63 F=0.110 p=0.896

No 98 31.6 112.51±36.55

Partly 200 64.5 111.80±36.13

Worrying about social media shares Yes 66 21.4 107.42±35.90

F=1.633 p=0.197

No 75 24.4 118.08±35.92 Partly 167 54.2 111.52±35.61

Contacting people newly met on social media on the net

Yes 107 35.3 112.79±37.01 T=0.281

No 196 64.7 111.58±35.33 P=0.779

Writing comments about social media content Yes 240 79.2 113.40±37.11 T=1.318

No 65 20.8 106.71±30.42 P=0.189

Comments made to social media content* Short responses 146 53.3 112.22±36.83

F=2.171 P=0.711

No response 30 11 115.10±31.23 Express my ideas honestly 98 35.7 113.98±40.16

Getting in touch with friends

No 16 5.1 106.00±16.28 F=0.356 p=0.701

Partly 79 25.5 113.78±35.61

Yes 215 69.4 111.04±37.62

For sharing messages with my friends

No 44 14.2 108.65±33.84 F=0.166 p=0.851

Partly 126 40.6 112.22±35.56

Yes 140 45.2 111.70±37.84

For sharing videos/photos/pictures

No 73 23.7 10.95±30.76 F=2.668 p=0.071

Partly 126 40.9 108.61±35.95

Yes 109 35.4 117.88±39.67

*Multiple options were chosen F: One-way ANOVA test MSQ: Moral Sensitivity Questionnaire

This study investigated professional development

oriented social media use of nursing students. It was

found that 41.9% of the students communicated

with their instructors and 61.9% of them got in

contact with their classmates about the courses by

using social media, 39.7% of them made use of social

media to improve their professional knowledge, and

that 23.2% did not use it for professional purposes.

It was also determined that through social media,

30.3% of the students communicated with nursing

associations, 29.7% of them shared problems related

to nursing and that 64.9% of them followed nursing-

related institutions. It was determined that 11% of

the nursing students shared things from the

class/clinical environment on social media. There

was no difference between the MSQ scores of the

students who used social media for their

professional purposes and those who did not use it

for this purpose (p>0.05; Table 3).

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Table 3. MSQ Mean Scores According to Students’ Social Media Use for Professional Development (n=316)

n % MSQ

Mean±SD Test

Communicating with instructors about the courses

No 80 25.8 110.66±34.52 F=0.311 p=0.733

Partly 100 32.2 109.71±32.72

Yes 130 42 113.35±39.94

Communicating with classmate friends about the courses

No 27 8.7 112.33±27.61 F=0.080 p=0.923

Partly 91 29.4 112.59±33.72

Yes 192 61.9 110.48±36.28

Developing professional knowledge No 72 23.2 113.12±30.70

F=0.319 p=0.727

Partly 115 37.1 109.35±33.64 Yes 123 39.7 112.51±41.49

Getting in contact with the students of other universities

No 120 38.8 109.38±34.19 F=0.408 p=0.665

Partly 104 33.5 113.77±31.64

Yes 86 27.7 111.63±43.85

Getting in contact with nursing students of other universities

No 111 35.8 108.58±33.50 F=0.553 p=0.576

Partly 103 33.2 112.91±33.99

Yes 96 31 113.30±41.54

Getting in touch with nursing associations No 83 26.8 109.97±34.73

F=0.111 p=0.895

Partly 133 42.9 111.69±34.39 Yes 94 30.3 112.51±40.36

Establishing links related to nursing

No 77 24.8 110.97±33.01 F=0.449 P=0.638

Partly 126 40.6 109.59±39.04

Yes 107 34.6 114.07±40.97

Sharing nursing-related problems No 80 25.8 108.58±32.28

F=0.442 p=0.643

Partly 138 44.5 111.61±34.99 Yes 92 29.7 113.80±41.35

Following nursing profession-related institutions on social media No 42 13.6 110.19±33.77

F=0.987 p=0.374

Partly 66 21.4 117.54±31.12 Yes 200 65 110.57±38.06

Sharing content from classroom/clinical environment on social media No 220 71.2 109.24±37.19

F=2.040 p=0.132

Partly 55 17.8 120.25±29.37 Yes 34 11 112.23±39.55

F: One-way ANOVA MSQ: Moral Sensitivity Questionnaire

DISCUSSION

The current study was conducted to evaluate the

impact of social media on nursing students' ethical

sensitivities and their professional development. The

higher the MSQ score is, the lower the ethical

sensitivity is and the lower the MSQ score is, the

higher the ethical sensitivity is. Accordingly, we can

say that the ethical sensitivity of nursing students

was at a medium level. In their study, Baykara,

Demir, Yaman (2015) and Akca et al., (2017) found

that the ethical sensitivity of nursing students was at

a medium level (Baykara, Demir, Yaman, 2015; Akça

et al., 2017). Ethical sensitivity is important for future

nurse candidates, and students' sensitivities should

be supported during their education. In our study, no

difference was found between students' ethical

sensitivities according to their classes, but the

sensitivity of the upper classes was relatively higher

(Table 1). In order for nursing students to solve the

ethical problems that they face, it is important that

they recognize, distinguish, and make appropriate

decisions about the ethical problems encountered.

In the literature, it has been stated that ethical

sensitivity and ethical decision making could be

increased by education (Robichaux, 2012; Kim, Knag,

Ahn, 2012; Park et al., 2012; Borhani, Abbaszadeh,

Mohsenpour, 2013; Dikmen, 2013; Ertuğ et al., 2014;

Baykara, Demir, Yaman, 2015; Sarı et al., 2018). With

increasing years of education, the number of ethical

problems increases in parallel with the number of

patients that the students meet in the clinical setting

and the amount of care experience they have. It is an

expected outcome of education that students are

more ethically sensitive and they recognize ethical

problems. However, students may not be able to

recognize ethical problems themselves and may

need guidance in this regard (Yeom, Ahn, Kim, 2017;

Lee, Huang, Huang, 2017).

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The examination of the ethical sensitivities of the

female and male students indicated that there was

no difference between their mean scores (Table 1).

The female and male students at this school have

been educated in the same school, at the same

department, and with the same teaching methods.

As a result, it is thought that their professional ideas

and perspectives may have been integrated into

each other, and therefore, create no difference

between them. It may be said that there is no

difference in their ethical sensitivities due to having

the same interactions. It is very important that

instructors should help students develop ethical

sensitivity so that they can be aware of the ethical

problems (Baykara, Demir, Yaman, 2015; Sarı et al.,

2018). The ethical sensitivity that grows up at school

will be strengthened more along the working life

professional.

It would not be wrong to say that nursing students

use social media for long hours and their interaction

with social media has become a habit (Table 2).

Today this constant use makes up a different and

new dimension of socialization among young people.

Studies report that people use social media for long

hours and it has a widespread use (Skiba, 2007; Vural

and Bat, 2010; Solmaz et al., 2013; Hamm et al.,

2013; Otrar and Argın, 2014; Green, Wyllie, Jackson,

2014; Tuominen, Stolt, Salminen, 2014; Duke et al.,

2017; Terzi et al., 2019; Mersin, et al., 2020).

Although students use social media too often, they

do not totally find social media contents credible and

trusted, and they are concerned about sharing

information on social media. Students often use

social media to communicate and share information

with their friends and familiar groups. The

information on social media is open to question

because most users do not use their real identities

when communicating on social media with others

across the world, the information on social media is

usually inaccurate and misleading, and people

sharing content on social media are not held

responsible for what they share (Solmaz et al., 2013;

Hamm et al., 2013; Otrar and Argın, 2014; Green,

Wyllie, Jackson, 2014).

The nursing students in the study reported that they

used social media to contribute to their professional

development and education. They mostly

communicated with their peers and their instructors

through social media. We think the reason why the

social media interactions of the students in this study

with the nursing students in other universities were

limited was that they did not trust those students

because they did not know them. We can say that as

a result of the fact that students do not trust social

media and that they do not get in contact with

people they do not know, their professional ethical

sensitivity was not affected so much, and therefore

this did not create any difference in their ethical

sensitivities. The students were found to follow

nursing organizations and nursing associations

through social media. The students’ sharing the

problems related to nursing on social media shows

their professional sensitivity and requirement for

professional development. Tuominen, Stolt,

Salminen (2014) stated that social media provides

group learning, develops social skills related to

nursing, and develops communication skills between

students and instructors (Tuominen, Stolt, Salminen,

2014). Studies also report that the use of social

media for educational purposes and its contribution

to the provision of resources in health education is

growing and that students can experience different

learning experiences from social media (Schmitt,

Sims­Giddens, Booth, 2012; Hamm et al., 2013;

Green, Wyllie, Jackson, 2014; Paterson et al., 2015;

Nemeth et al., 2016; Watson, Cooke, Walker, 2016;

Ferguson et al., 2016; Duke et al., 2017; Terzi et al.,

2019; Alharbi, Kuhn, Morphet, 2020).

Professional interaction through social media is

becoming inevitable today. Students who are future

nurses can create professional associations with

their colleagues on social media. It will be helpful for

students to use social media for their professional

development. Studies conducted so far support this

view (Watson, Cooke, Walker, 2016; Ferguson et al.,

2016; Duke et al., 2017; Terzi et al., 2019; Alharbi,

Kuhn, Morphet, 2020). Instructors can direct

students to reliable vocational training websites.

Thus, students can have professional interaction in

reliable environments more comfortably and can

support their professional development and

education in a positive way. In our study, 18% of the

nursing students reported that they shared content

on social media from class / clinical environment

Eraydın & Erkoç Hut / TFSD, 2021, 2(1), 156-165

163

partially, while 11% did it wholly (Table 3).

Restricting social media sharing is not possible today.

Nowadays, people are increasingly sharing content

on social media from every medium. The

opportunities offered by social media on the internet

provide mutual and constant interaction between

people, regardless of time and place (Green, Wyllie,

Jackson, 2014; Mersin, et al., 2020). This situation

involves the dangers of rapid dissemination of

information on social media, rapid sharing among

networks, the violation of privacy, and copying of

ideas and information. In this respect, unethical and

inappropriate networking may be dangerous and

alarming and may cause ethical violations and ethical

problems (George and Dellasega, 2011; Schmitt,

Sims­Giddens, Booth, 2012; Tuominen, Stolt,

Salminen, 2014; Nemeth et al., 2016; Uppal et al.,

2016; Ferguson et al., 2016). Some nursing

associations have prepared publications on the

ethical use of social media. They have identified the

principles of social media use of nurses and students

in these publications (New Zealand Nurses

Organization, 2012; The Nurses Association of New

Brunswick. 2012; Canadian Nurses Association,

2012). In our study, although students’ sharing from

the class / clinical environment is not considered as

malicious, it can be said that it would be beneficial to

draw their attention to this issue and to inform them

in order to create ethical sensitivity about these

shares. Quality and reliable social media content is

needed for all healthcare teams, trainers and

students and this should be supported (Paterson et

al., 2015). Ethical sensitivity should be established in

social media sharing. In a virtual internet

environment, people can share personal

information, photos and videos with multiple uses.

Students should be informed about personal rights

and patient rights.

CONCLUSION

In our study, the ethical sensitivity of nursing

students was found to be at a medium level. There

was no difference in the ethical sensitivity of the

students in terms of gender and classes. Students

were found to not trust social media content and

were concerned about sharing. They shared content

only with people they know. They were determined

to use social media for their professional

development and education. It can be said that the

use of social media can be increased with reliable

professional knowledge and ethical sensitivity. In

future studies, it can be suggested that students'

social media sharing should be investigated in depth

in terms of ethical and unethical aspects by

conducting qualitative and quantitative studies.

Conflict of Interest

The authors confirm that they do not have any

conflict of interests. This research did not receive any

specific grant from public, commercial, or non- profit

funding agencies.

REFERENCES Acun, İ., Yücel, C., Belenkuyu, C., et al. (2017). Examination

of social media use of university students. Educational Administration: Theory and Practice 23(4), 559-602. Doi: 10.14527/kuey.2017.018

Akbaş, M., Tuncer, I., Kadıoğlu, S. (2014). The status of ethical education at undergraduate level nursing schools. Deuhyo. Ed., 7(3), 206-211.

Akça, N, K., Şimsek, N., Arslan, D, E., et al. (2017). Moral sensitivity among senior nursing students in Turkey. International Journal of Caring Sciences, 10(2), 1031-1039.

Alharbi, M., Kuhn, L., Morphet, J. (2020). Undergraduate nursing students' adoption of the professional identity of nursing through social media use: A qualitative descriptive study. Nurse Education Today, 104488. https://doi.org/10.1016/j.nedt.2020.104488

Barton, A, J., Skiba, D, J. (2012). Creating social media policies for education and practice. NI2012: 11th International Congress on Nursing Informatics, 16-20.

Başak, T., Uzun, Ş., Arslan, F. (2010). Investigation of the moral sensibility of intensive care nurse, Gülhane Medical Journal, 52, 76-81.

Baykara, Z, G., Demir, S, G., Yaman, Ş. (2015). The effect of ethics training on students recognizing ethical violations and developing moral sensitivity, Nursing Ethics, 22(6), 661-675.

https://doi.org/10.1177/0969733014542673 Borhani, F., Abbaszadeh, A., Mohsenpour, M. (2013).

Nursing students’ understanding of factors influencing ethical sensitivity: A qualitative study, Iranian Journal of Nursing and Midwifery Research, 18(4), 310-315.

Burkhard, M. A., Nathaniel, A. K. (2013). Ethics in Contemporary Nursing. İstanbul Tıp Kitabevi, İstanbul.

Button, D., Harrington, A., Belan, I. (2014). E­learning & information communication technology (ICT) in nursing education: A review of the literature. Nurse Education Today, 34(10), 1311–1323. https://doi.org/10.1016/ j.nedt.2013.05.002

Canadian Nurses Association (CNA) 2012. When private

Eraydın & Erkoç Hut / TFSD, 2021, 2(1), 156-165

164

becomes public: the ethical challenges and opportunıtıes of socıal media. Ethics in Practice for Registered Nurses.www.cna-aiic.ca.

Cerit, B., Dinc, L. (2013).Ethical decision-making and professional behavior among nurses: a correlational study. Nurs Ethics, 20, 200-212. https://doi.org/10.1177/0969733012455562

Cerit, B. (2010). A study of validity and reliability of nursing dilemma test and nurses’ level of ethical decision-making. Hacettepe University Faculty of Health Sciences Nursing Journal, 17(2), 47-67.

Comrie, R, W. (2012). An analysis of undergraduate and graduate student nurses’ moral sensitivity, Nursing Ethics, 19 (1), 116-127.

https://doi.org/10.1177/0969733011411399 Dikmen, Y. (2013). An observation on the moral sensibility

of intensive care nurses. Cumhuriyet Nursing Journal, 2 (1), 1-7.

Egüz, Ş., Kesten, A. (2018). Identification of perceptions of social media in student-teachers of social studies through metaphors. Cumhuriyet International Journal of Education, 7(3), 219-240. http://dx.doi.org/10.30703/cije.403147

Erdil, F., Korkmaz, F. (2009). Ethical problems observed by student nurses, Nurs. Ethics, 16, 589-598. https://doi.org/10.1177/0969733009106651

Ertuğ, N,, Aktaş, D., Faydali, S., et al. (2014). Ethical sensitıvity and related factors of nurses working in the hospital settings. Acta Bioethica, 20(2), 265-270.

Farrelly, R. (2014). Nurses and Social Media, British Journal of Nursing, 23(6), 342-343. https://doi.org/10.12968/bjon.2014.23.6.343

Ferguson, C., DiGiacomo, M., Saliba, B., et al. (2016). First year nursing students’ experiences of social media during the transition to university: A focus group study. Contemporary Nurse, 52(5), 625–635. https://doi.org/10.1080/10376178.2016.1205458

George, D. R., Dellasega, C. (2011). Use of social media in graduate-level medical humanities education: Two pilot studies from Penn State College of Medicine. Medical Teacher, 33, e429-e434. https://doi.org/10.3109/0142159X.2011.586749

Green, J., Wyllie, A., Jackson, D. (2014). Social networking for nurse education: Possibilities, perils and pitfalls, Contemporary Nurse, 47 (1-2), 180-189. https://doi.org/10.1080/10376178.2014.11081919

Gül, Ş., Duru-Aşiret, G., Bayrak-Kahraman, B., et al. (2013). Investigating ethical decision-making levels of nursing students who did and did not take ethics course, Turkish Journal of Research and Development in Nursing, 15 (1), 23-31.

Hamm, M, P., Chisholm, A., Shulhan, J., et al. (2013). Social media use by health care professionals and trainees: A scoping review, Academic Medicine, 88 (9), 1376-1388.

Doi: 10.1097/ACM.0b013e31829eb91c Jones, R., Kelsey, J., Nelmes, P., et al. (2016). Introducing

Twitter as an assessed component of the undergraduate nursing curriculum: Case study.

Journal of Advanced Nursing, 72(7), 1638–1653. https://doi.org/10.1111/jan.12935.

Kim, Y, S., Knag, S, W., Ahn, J, A. (2012). Moral sensitivity relating to the application of the code of ethics, Nursing Ethics, 20 (4), 470-478.

https://doi.org/10.1177/0969733012455563 Lee, H,L., Huang, S,H., Huang, C,H. (2017). Evaluating the

effect of three teaching strategies on student nurses’ moral sensitivity. Nursing Ethics, 24 (6), 732-743.

https://doi.org/10.1177/0969733015623095 Leuter, C., Petrucci, C., Mattei, A., et al. (2012). Ethical

difficulties in nursing, educational needs and attitudes about using ethics resources. Nursing Ethics, 20(3), 348-358.

https://doi.org/10.1177/0969733012455565 Mersin, S., İbrahimoğlu, Ö., Saray Kılıç, H., et al. (2020).

Social media usage and alexithymia in nursing students. Perspectives in Psychiatric Care, 56(2), 401-408. https://doi.org/10.1111/ppc.12448

Nemeth, J, K., Allison, A, E., Travis, L, D., et al. (2016). Using social media to disseminate published evidence to nurses in a health system. Journal of Electronic Resources in Medical Libraries, 13(2), 77-85. https://doi.org/10.1080/15424065.2016.1197080

New Zealand Nurses Organisation. (2012). Social media and the nursing profession: a guide to online professionalism for nurses and nursing students. https://www.nzno.org.nz/LinkClick.aspx

Otrar, M., Argın, F, S. (2014). The examination of the students’ attitudes towards social media within the context of habits, Journal of Research in Education and Teaching, 3(3), 1-13.

Öztürk, H., Hintistan, S., Kasım, S., et al. (2009). Ethical sensitivity of physicians and nurses in ıntensive care units, Journal of İntensive Care Nursing, 13(2), 77-84.

Park, M., Kjervik, D., Crandell, J., et al. (2012). The relationship of ethics education to moral sensitivity and moral reasoning skills of nursing students, Nursing Ethics, 19(4), 568–580.

https://doi.org/10.1177/0969733011433922 Paterson, Q, S., Thoma, B., Milne, W, K., et al.(2015). A

systematic review and qualitative analysis to determine quality ındicators for health professions education blogs and podcasts, Journal of Graduate Medical Education, 12, 549-554. http://dx.doi.org/10.4300/JGME-D-14-00728.1

Robichaux, C. (2012). Developing ethical skills: from sensitivity to action, Critical Care Nurses, 32(2), 65–72.

https://doi.org/10.4037/ccn2012929 Sarı, D., Baysal, E., Celik, G, G., et al. (2018). Ethical

Decision Making Levels of Nursing Students, Pakistan journal of medical sciences, 34(3), 724-729.

https://doi.org/10.12669/pjms.343.14922 Schmitt, T, L., Sims­Giddens, S, S., Booth, R, G. (2012).

Social media use in nursing education. OJIN: The Online Journal of Issues in Nursing, 17(3), 1-11. DOI: 10.3912/OJIN.Vol17No03Man02

Skiba, D, J. (2007). Nursing Education 2.0: YouTube, Nursing Education Perspectives, 28(2), 100-102.

Eraydın & Erkoç Hut / TFSD, 2021, 2(1), 156-165

165

Solmaz, B., Tekin, G., Herzem, Z., et al. (2013). An application on the use of internet and social media. Journal of Selçuk Comunication, 7(4), 23-32.

The Nurses Association of New Brunswick (2012). Practice Guideline Ethical and Responsible Use Of Social Media Technologies. http://www.nanb.nb.ca/

Tuominen, R., Stolt, M., Salminen, L. (2014). Social Media in Nursing Education: The View of the Students. Education Research International, 1-6, ID929245, http://dx.doi.org/10. 1155/2014/929 245

Tosun, H. (2018). Moral Sensitivity Questionnaire (MSQ): Turkish Adaptation of the Validity and Reliability. J Contemp Med, 8(4): 316-321. https://doi.org/10.16899/gopctd.467052

Vural, B, A., Bat, M. (2010). Social Media as a New Communication Environment: A Research on Ege University Faculty of Communication. Journal of Yaşar University, 20(5); 3348­3382.

Watson, B., Cooke, M., Walker, R. (2016). Using Facebook to enhance commencing student confidence in clinical skill development: A phenomenological hermeneutic study. Nurse Education Today, 36, 64–69. https://doi.org/ 10.1016/j.nedt.2015.07.019

Yeom, H, A., Ahn, S, H., Kim, S, J. (2017). Effects of ethics education on moral sensitivity of nursing students. Nursing Ethics, 24 (6), 644–652.

https://doi.org/10.1177/0969733015622060